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Bad Medicine: Study Finds Problems with Online Healthcare Information

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Searching for health information on the web? Be careful: A new study says that it's difficult for many people to accurately access and evaluate credible health information.

High quality, reliable health information abounds on the web, from such sources as the Centers for Disease Control and the National Library of Medicine's PubMed. Directories like the U.K.'s OMNI Gateway serve as trusted guides to many other credible sources.

The problem is that many people aren't aware of these resources. And many other, often quite dubious sources of information, are promoted heavily and easily found with search engines, posing a risk for users who accept the information or products offered by these sites without critical judgement.

A new study (news release, pdf report) by medical consumer advocate URAC and Consumer WebWatch details the problems consumers have finding credible health information, and provides recommendations to improve the situation.

The study cites four primary problems with finding reliable health care information on the web.

Two reasons have to do with the knowledge and skill of web users. Many consumers' ability to locate and evaluate health information online is hindered by access barriers for older, less well off, disabled, and non-English speaking Americans. Many people also lack critical thinking skills, having problems distinguishing credible health information from that which is not trustworthy.

Of course, lack of critical thinking skills is a problem in many parts of life, both online and off -- think of the recurring Ponzi schemes that promise too good to be true investment returns, only to inevitably collapse. But for some reason, even otherwise sensible people lower their guard when it comes to email and the web.

The study also found problems with the web itself. Many web sites contain inaccurate, outdated or incomplete information. And of particular note, the study found that many consumers had a lack of knowledge about how search engines retrieve results, and didn't realize that paid placements listings can be featured prominently on search engine result pages without regard to quality.

"Searches for health information are one of the most common reasons consumers use the Internet," said Garry Carneal, URAC president and CEO. "One of our greatest challenges is helping consumers find the information they want that is also accurate, reliable and presented in an accessible format."

"Consumers can easily be misled by incomplete, inaccurate, outdated, even outright biased health information they find on the Internet," said Beau Brendler, director of Consumer WebWatch. "A simple Web search can become a dangerous enabling tool, pointing consumers to sites that peddle drugs without prescriptions. The search engine community could do better in taking responsibility for its paid content."

The extent of this dilemma can be illustrated by a search for the phrase "cancer treatment" on Google, Yahoo, and Ask Jeeves. While the algorithmic results from all three engines surfaced many credible, authoritative sources in the top ten results, all three also prominently featured sponsored listings for things such as "heat treatment" "herbal treatment" or other non-approved therapies.

In fairness to the search engines, all of these results are labeled as sponsored listings. And some of these sponsored listings come from unquestionably reliable sources, such as the Memorial Sloan-Kettering
Cancer Center. But numerous studies have suggested that many consumers don't easily distinguish between paid and algorithmic results. My own informal surveys in workshops suggests that even information professionals don't always know the difference.

"As more and more people seek medical information through the Internet it is increasingly important to evaluate and improve the process they use," said Ray Fabius, MD, GE Global Medical Leader and a participant in the URAC/CWW national summit. "Our ultimate goal is to help patients get to the best answers to their medical questions quickly in a format that is easy to understand. Actively involved and well-informed health care consumers will drive the market in a positive way."

As the search engines continue to compete against one another for user eyeballs, I'm confident that they will increasingly help users understand the difference between paid and unpaid results. We've already seen a dramatic improvement in disclosure, ever since the FTC issued guidelines for search engines in 2002.

Meanwhile, we can polish our own critical information skills, and help others get better at evaluating the quality of web sites. One of the best resources I've come across for this type of skill-building is Genie Tyburski's Evaluating the Quality of Information on the Internet. This tutorial has a great checklist to apply to individual web sites, a guide to recognizing technical trickery, and numerous other resources for improving your own "information IQ."

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